The Centers for Medicare & Medicaid Servicers (CMS) Innovation Center has announced a four year, pilot initiative to pay primary care practices a care management fee, initially set at an average of $20 per beneficiary per month, to support enhanced, coordinated services. Participating commercial, State, and other federal insurance plans will also offer enhanced payments to primary care practices that provide high-quality primary care.
The Comprehensive Primary Care initiative involves the cooperative efforts of 45 commercial, federal and State insurers in Arkansas, Colorado, New Jersey, Oregon, New York’s Capital District-Hudson Valley Region, Ohio’s and Kentucky’s Cincinnati-Dayton Region, and greater Tulsa, Oklahoma.
To receive the new care management fee from CMS and insurers, primary care practices must agree to provide enhanced services for their patients, including:
- offering longer and more flexible hours
- using electronic health records
- delivering preventive care
- coordinating care with patients’ other health care providers
- engaging patients and caregivers in managing their own care, and
- providing individualized, enhanced care for patients living with multiple chronic diseases and higher needs.
Approximately 75 primary care practices will be selected to participate in each designated market. Interested primary care practices in each of the markets should complete the application pre-screen tool. This is the first step in applying for the program. Practices will not be allowed to submit an application without a completed application pre-screen tool. Applications will be accepted until July 20.
Tags: Physician Reimbursement